Individual
GAVIN ELLIOT ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10301 HAGEN RANCH RD STE B6, BOYNTON BEACH, FL 33437-3723
(888) 852-6672
(561) 752-9490
Mailing address
1065 NE 125TH ST STE 409, NORTH MIAMI, FL 33161-5834
(888) 852-6672
(877) 720-0502
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
ME97253
FL
2084P0800X
Psychiatry Physician
Primary
ME97253
FL
Other
Enumeration date
09/11/2009
Last updated
04/19/2019
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